Hi, I found out I had AIDS in 1995 with a VL of 180,000 and a cd4 of 176, since then I have gone to a VL of undetectable and some up and downs, and a CD4 of over 900 now. My problem is I have never had any problem dealing with this except for now I seem to have become much more irratbale than before I snap at the smallest problem and can't seem to understand why I feel this way. I sleep more that ever and when I am not it seems to be the only thing I feel like doing, I know this is typical of depression but I have nothing to be depressed about I am doing fine in every part of my life. I have not discussed this with my Doc yet but I plan on it at my next visit within a few weeks.

I do not think I can sit down and discuss my life with a therapist or counseler I have always lived a private life and that would just not feel right to me, so my options are limited. Can this be from all the drugs i am taking, I do feel sometimes that my life now is controlled by my Meds, but without them I would have been gone 3 years ago so what do I do I will consider any help you can give. Thanks Rj

Dear Rj,

I am really surprised that you say that you do not feel that you have anything to be depressed about. That is a very naive statement. You are living with a life threatening illness. Yes, currently you are responding well to the treatments, but medical science is not certain of how long these treatments will remain effective or what the long term effects on our bodies will be after many years of taking them. You have some very real things to be anxious or depressed about. There is a very potent uncertainty that has to be totally permeating your entire existence. This can certainly contribute to feeling depressed. Additionally you say that you feel that your life feels like it is controlled by your meds. The amount of loss of control you are feeling over your life as a result of having HIV and being treated with the medications you are taking are additional circumstances that are very likley contributing to your feeling depresed.

The symptoms you describe certainly sound like a serious clinical depression. I would urge you to call your doctor and ask him or her to refer you to a psychiatrist who is knowledgeable about working with people who have HIV. You need to have a consultation with a psychiatrist. Very likely he or she will suggest that you begin anti-depressant medication. After several weeks the medication will probably help you to feel better. But this is really not a long term solution to what is ailing you.

I know that you said that you are a private person. But you are seriously limiting your own options as well as the opportunity for you to work through these issues and learn how to emotionally accomodate to your circumstances in an adaptive way by refusing to consider going to therapy. You do not have to remain in therapy for months or years. Though considering the situation you describe, I really feel that at least a few months of psychotherpay is indicated. Please rethink your feelings aobut not wanting to give therapy a try. What do you have to lose if you do try it out for awhile? If you don't like it, you can always stop going to therapy. Please reconsider your position. Michael Shernoff, MSW